Prediction of recurrent clostridium difficile infection at the bedside: the GEIH-CDI score

• Published in: International journal of antimicrobial agents Vol. 51; no. 3; pp. 393 - 398
• Main Authors: Cobo, Javier, Merino, Esperanza, Martínez, Cristina, Cózar-Llistó, Alberto, Shaw, Evelyn, Marrodán, Teresa, Calbo, Esther, Bereciartúa, Elena, Sánchez-Muñoz, Luis A., Salavert, Miguel, Pérez-Rodríguez, M. Teresa, García-Rosado, Dácil, Bravo-Ferrer, J. María, Gálvez-Acebal, Juan, Henríquez-Camacho, César, Cuquet, Jordi, Pino-Calm, Berta, Torres, Luis, Sánchez-Porto, Antonio, Fernández-Félix, Borja M., Romero, José, Muriel, Alfonso, Giner, Livia, Boix, Vicente, Ramos-Martínez, Antonio, Martínez, Rocío, Martos, Purificación, Arch, Olga, Sardiña, Cristina, Aguirre, Elena, Badía, Cristina, Boix, Lucía, Perales, Ildefonso, De Santos-Castro, Pedro A., Bratos-Pérez, Miguel Angel, Cuellar, Sandra, González, Eva, Soto, Adriana, Sousa, Adrián, Llinares, Pedro, Castelo, Laura, Morales, Isabel, Sojo, Jesús, Delgado-Iribarren, Alberto, Martí, Carmina, Vázquez, Rosa, Mairal, Pilar
• Format: Journal Article
• Language: English
• Published: Netherlands Elsevier B.V 01.03.2018
• Subjects: Clinical prediction tool; Clostridium difficile; Recurrence; Recurrence; Clinical prediction tool; Clostridium difficile
• ISSN: 0924-8579; 1872-7913
• DOI: 10.1016/j.ijantimicag.2017.09.010

•Based on data from a large cohort of patients, a clinical tool for prediction of recurrent CDI has been developed.•The tool makes it possible to identify a subgroup of patients with a high probability of recurrence.•The tool enables clinicians to select patients for new and expensive therapies that reduce the risk of recurrence. Recurrence of Clostridium difficile infection (CDI) has major consequences for both patients and the health system. The ability to predict which patients are at increased risk of recurrent CDI makes it possible to select candidates for treatment with new drugs and therapies (including fecal microbiota transplantation) that have proven to reduce the incidence of recurrence of CDI. Our objective was to develop a clinical prediction tool, the GEIH-CDI score, to determine the risk of recurrence of CDI. Predictors of recurrence of CDI were investigated using logistic regression in a prospective cohort of 274 patients diagnosed with CDI. The model was calibrated using the Hosmer-Lemeshow test. The tool comprises four factors: age (70–79 years and ≥80 years), history of CDI during the previous year, direct detection of toxin in stool, and persistence of diarrhea on the fifth day of treatment. The functioning of the GEIH-CDI score was validated in a prospective cohort of 183 patients. The area under the ROC curve was 0.72 (0.65–0.79). Application of the tool makes it possible to select patients at high risk (>50%) of recurrence and patients at low risk (<10%) of recurrence. GEIH-CDI score may be useful for clinicians treating patients with CDI.